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End-of-life care for Chronic disease

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#1 Thu, 04/19/2012 - 20:12
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End-of-life care for Chronic disease

Is there practical guidelines or evidence-based signs to guide clinicians about WHEN to start "palliative care" for "roller-coaster" disease trajectory of chronic non-cancer disease such as Congestive Heart Failure and COPD?

If so, what is the goldstandard reference source of information (Palliative care textbooks typically discuss about Cancer... not much about end-stage chronic medical problems)

from Dr Cuong Ngo-Minh